他汀类药物与运动的相互作用：应对这种联合治疗肌肉骨骼副作用的机制与策略。
The Interaction Between Statins and Exercise: Mechanisms and Strategies to Counter the Musculoskeletal Side Effects of This Combination Therapy.
作者信息
Deichmann Richard E, Lavie Carl J, Asher Timothy, DiNicolantonio James J, O'Keefe James H, Thompson Paul D
机构信息
Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA ; Department of Cardiovascular Diseases, John Ochsner Heart & Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA.
出版信息
Ochsner J. 2015 Winter;15(4):429-37.
BACKGROUND
Broad indications for the use of statin medications are resulting in more patients using these therapies. Simultaneously, healthcare professionals are strongly advocating recommendations to increase exercise training (ET) as a means of decreasing cardiovascular disease (CVD) risk and improving other parameters of fitness.
METHODS
We review the literature to explore mechanisms that may increase the risk of statin/ET interactions, examine the benefits and risks of combining ET and statin use, and offer strategies to minimize the hazards of this combination therapy.
RESULTS
The combined use of statins and ET can result in health gains and decreased CVD risk; however, multiple factors may increase the risk of adverse events. Some of the events that have been reported with the combination of statins and ET include decreased athletic performance, muscle injury, myalgia, joint problems, decreased muscle strength, and fatigue. The type of statin, the dose, drug interactions, genetic variants, coenzyme Q10 deficiency, vitamin D deficiency, and underlying muscle diseases are among the factors that may predispose patients to intolerance of this combined therapy.
CONCLUSION
Effective strategies exist to help patients who may be intolerant of combined statin therapy and ET so they may benefit from this proven therapy. Careful attention to identifying high-risk groups and strategies to prevent or treat side effects that may occur should be employed.
背景
他汀类药物广泛的使用适应症导致越来越多的患者采用这些疗法。与此同时，医疗保健专业人员强烈倡导增加运动训练（ET）的建议，以此作为降低心血管疾病（CVD）风险和改善其他健康参数的一种手段。
方法
我们查阅文献，以探索可能增加他汀类药物/运动训练相互作用风险的机制，研究联合使用运动训练和他汀类药物的益处和风险，并提供将这种联合治疗的危害降至最低的策略。
结果
他汀类药物和运动训练的联合使用可带来健康益处并降低心血管疾病风险；然而，多种因素可能增加不良事件的风险。他汀类药物和运动训练联合使用时报告的一些事件包括运动表现下降、肌肉损伤、肌痛、关节问题、肌肉力量下降和疲劳。他汀类药物的类型、剂量、药物相互作用、基因变异、辅酶Q10缺乏、维生素D缺乏以及潜在的肌肉疾病等因素可能使患者易于对这种联合治疗不耐受。
结论
存在有效的策略来帮助那些可能对他汀类药物和运动训练联合治疗不耐受的患者，以便他们能从这种经过验证的治疗中获益。应仔细关注识别高危人群以及预防或治疗可能出现的副作用的策略。
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